Page 1

West Virginia WIC Policy & Procedure 3.16 Effective Date: 7/5/2017 3.16 Special Formula Distribution System POLICY: Special formula will be provided by the State contracted distribution center. The distribution center will ship requested special formula to either the Local Agency clinic or the participant’s home considering which one is more appropriate. DEFINITIONS: Out-of-Date Formula: Formula is considered out-of date on the first day of the month labeled as the expiration date. PROCEDURE: A. Local Agency Determination of Special Formula Need The Local Agency will determine:

Participant eligibility to receive special formula;

Quantity and type of special formula to be issued to the participant; < Review whether formula is to be issued to the EBT card or the CAP Warehouse from the Food Package Reference Guide;

Location to which special formula will be shipped. B. Local Agency Special Formula Order The Local Agency Staff will:

Order the CAP Warehouse order through the Formula wizard button on the Crossroads Food Issuance Screen;

Ensure the WIC 53 is completely filled out and that it has not expired;

Obtain the participant’s signature on all formula food benefits issued to the participant;

Determine if the formula is to be shipped directly to the client’s physical address or clinic;

Will scan the WIC-53 into Crossroads on the Food Prescription Screen. C. Special Formula Shipment to Participant’s Home 1. When formula is sent to participant’s home, the distribution center must have a physical address (not a Post Office Box). A physical address must be documented in Crossroads for that participant. For special formula only, a rural route and box number is permissible as a physical address in Crossroads. 2. Local Agency clinic staff should inform the participant when to expect delivery. This will normally be 2-4 business days after the order is placed. 3. The participant should be instructed that if the order is not received within five (5) business days, the Local Agency clinic should be contacted. The clinic will then contact the distribution center to trace the order. Do not give the distribution center phone number to the participants. 1 of 5